Introduction: Involvement of the thyroid gland in extra-pulmonary tuberculosis is extremely rare. A midline neck abscess is the rarest form of presentation. Case Report: We present a 39-year-old Asian male with a known history of tubercular thyroiditis that presented with a history of pyrexia, cervical lymphadenopathy and a discharging neck abscess overlying the thyroid gland that required surgical drainage and medical treatment. The patient was left with a discharging sinus which completely resolved after five months. Conclusion: Although early diagnosis for extra-pulmonary tuberculosis may be challenging, tubercular thyroiditis remains an important differential diagnosis in a world where populations are becoming increasingly dynamic, with respect to migration and urbanization, causing increased spread of infectious disease.